1629011341 NPI number — ABINGDON RADIOLOGY SERVICES LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629011341 NPI number — ABINGDON RADIOLOGY SERVICES LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABINGDON RADIOLOGY SERVICES LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629011341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 918
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ABINGDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24212-0918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-628-9331
Provider Business Mailing Address Fax Number:
276-628-1093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL DRIVE
Provider Second Line Business Practice Location Address:
GLENROCHIE PROFESSIONAL BLDG
Provider Business Practice Location Address City Name:
ABINGDON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-628-9331
Provider Business Practice Location Address Fax Number:
276-628-1093
Provider Enumeration Date:
06/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MULLENS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
276-628-9331

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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